The Comparative Efficacy Between Intralesional Steroids and Oral Prednisolone Mini Pulse Therapy in The Treatment of Alopecia Areata (AA).

Abstract

Background: Alopecia areata (AA) is a common auto-immune condition, causing hair loss. This disease has limited treatment modalities. Through this study, comparison between established modalities of treatment such as oral mini pulse therapy, intralesional corticosteroids and platelet-rich plasma (PRP) as a newer modality has been done. The objective of the study was to evaluate the efficacy and safety of various treatment modalities in alopecia areata.
Methods: A total number of one hundred twenty patients with clinical manifestation of alopecia areata attending the dermatology outpatient department of Nalanda Medical College, Patna were included in this study. It was conducted as a randomized prospective study for a period of 16 weeks. After taking informed consent, patients were randomly distributed into three treatment groups. Group 1 patients were treated with Tab. Betamethasone 0.1 mg/kg every Saturday and Sunday, Group 2 was treated with Inj. Triamcinolone acetonide 10 mg/ml for scalp and 2.5 mg/ml for eye brows and face was injected into deep dermis.
Results- The commonest age group was 20 years and below with the total mean age being 24.9 years. Males showed predominance with a ratio of male to female of 2:1. Majority of the patients presented between 2 month to 3 month after the onset. Family history of AA was present in 12% of the subjects. The common patterns of alopecia areata observed in our study was patchy AA .22(18.3%) patients had an association of atopy and 3(2.5%) of the patients had a history of vitiligo. Majority of the patients did not take treatment prior to the onset (93%). Nail changes were observed in 9(7.5%) patients .
Conclusions: Intralesional corticosteroids viz. triamcinolone acetonide still remains the first choice of therapy for AA in adults with limited involvement. Systemic corticosteroids give lower response than intralesional steroids.